Low back pain induces disability of women in primary uncomplicated pregnancy
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Abstract
Study design: A consecutive case series study
Purpose: To investigate whether Low Back Pain (LBP) in women with primary singleton pregnancy induces disability.
Background: LBP is reported to be increased in pregnants than in non-pregnant women. Different outcome measures have been used to search for correlations between pain and disability.
Methods: 167 pregnant women aged 30 ± 3.5 years participated. Two equal categorial age groups were constructed: Group A included women aged 23 - 29 years, and Group B women aged 30-39 years. Their weight was 76 ± 13 kg prepartum and the Body Mass index (BMI) was 28 ± 4 prepartum. Visual Analogue Scale (VAS) was used for LBP pain intensity and Oswestry Disability Scale (ODI) for disability estimation in the last three months prepartum and in the first three months postpartum.
Results: The women weight was 67 ± 13 kg postpartum. The BMI was 24 ± 4 postpartum. There was no difference in VAS and ODI scores versus BMI, weight and height between the two age groups in both periods of observation: prepartum and postpartum. Prepartum, 81.4% of women claimed LBP that dropped to 55.5% postpartum. ODI score dropped from 19.5 ± 13.6% prepartum to 11 ± 12% postpartum. The ODI subscales that showed significant reduction postpartum were: Pain intensity (P = 0.002); working (P = 0.009); sitting (P = 0.004); standing (P = 0.003); sleeping (P = 0.008); and traveling (P = 0.006). VAS prepartum was increasing as the weight was increasing in both periods of observation (P = 0.015 and P=0.051) respectively. VAS prepartum was significantly correlated with BMI prepartum (P = 0.019) and postpartum (P = 0.028).
Discussion: Physical disability in pregnant women was low and reduced following delivery. Disability was linked with LBP intensity, weight, BMI and height, but not with age or educational level.
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Copyright (c) 2019 Korovessis P, et al.

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Kovacs FM, Garcia E, Royuela A, Gonzalez L, Abraira V, et al. Prevalence and factors associated with low back and pelvic girdle pain during pregnancy: a multicentre study conducted in the Spanish National Health Service. Spine. 2012; 37: 1516–1533. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22333958
Gutke A, Josefsson A, Oberg B. Pelvic girdle pain and lumbar pain in relation to postpartum depressive symptoms. Spine. 2007; 32: 1430–1436. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/17545912
Perkins J, Hammer RL, Loubert PV.Identification and management of pregnancy-related low back pain. J Nurse Midwifery. 1998; 43: 331–340. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/9803711
Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J. 2008; 17: 794-819. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18259783
Ostgaard HC, Andersson GB, Karlsson K. Prevalence of back pain in pregnancy. Spine. 1991; 16: 549-552. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/1828912
Ostgaard HC, Roos-Hansson E, Zetherstrom G. Regression of back and posterior pelvic pain after pregnancy. Spine. 1996; 21: 2777–2780. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/8979325
Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B. European guidelines on the diagnosis and treatment of pelvic girdle pain. Eur Spine J. 2008; 17: 794-819.
Boscainos PJ, Sapkas G, Stilianessi E, Prouskas K, Papadakis SA. Greek versions of the Oswestry and Roland-Morris Disability Questionnaires. Clin Orthop Relat Res. 2003; 411: 40-53. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12782858
Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976). 2000; 25: 2940-2952. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11074683
Lagadec N, Steinecker M, Kapassi A, Magnier AM, Chastang J, et al. Factors influencing the quality of life of pregnant women: a systematic review. BMC Pregnancy Childbirth. 2018; 18: 455. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/30470200
Altman DG, Bland JM. Measurement in Medicine: The Analysis of Method Comparison Studies. The Statistician. 1983; 32: 307-317.
Korovessis P, Repantis T, Zacharatos S, Baikousis A. Low back pain and sciatica prevalence and intensity reported in Mediterranean country: ordinal logistic regression analysis. Orthopedics. 2012; 35: e1775-1784. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23218636
Gutke A, Olsson CB, Völlestad N, Öberg B, Wikmar LN, et al. Association between lumbopel¬vic pain, disability and sick leave during pregnancy - a comparison of three Scandinavian cohorts. J Rehabil Med. 2014; 46: 468-474. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24763944
Mogren IM. BMI, pain and hyper-mobility are determinants of long-term outcome for women with low back pain and pelvic pain during pregnancy. Eur Spine J. 2006; 15: 1093-1102. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16404613
Ostgaard HC, Zetherstrom G, Roos-Hansson E. Back pain in relation to pregnancy: a 6-year follow-up. Spine. 1997; 22: 2945-2950. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/9431631
van Dongen PW, de Boer M, Lemmens WA, Theron GB. Hypermobility and peripartum pelvic pain syndrome in pregnant South African women. Eur J Obstet Gynecol Reprod Biol. 1999; 84: 77-82. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/10413232
Duarte VM, Meucci RD, Cesar JA. Severe low back pain among pregnant women in Southern Brazil. Cien Saude Colet. 1918; 23: 2487-2494. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/30137118
Melzack R, Bélanger E. Labour pain: correlations with menstrual pain and acute low-back pain before and during pregnancy. Pain. 1989; 36: 225-229. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/2521931
Sihvonen T, Huttunen M, Makkonen M, Airaksinen O. Functional changes in back muscle activity correlate with pain intensity and prediction of low back pain during pregnancy. Arch Phys Med Rehabil. 1998; 79: 1210-1212. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/9779673
Tzeng YL, Su TJ. Low back pain during labor and related factors. J Nurs Res. 2018; 16: 231-241. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18792893
Mens JM, Vleeming A, Stoeckart R, Stam HJ, Snijders CJ. Understanding peripartum pelvic pain. Implications of a patient survey. Spine. 1996; 12: 1363-1369. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/8725930
Sydsjo A, Sydsjo G, Wijma B. Increase in sick leave rates caused by back pain among pregnant Swedish women after amelioration of social benefits. A paradox. Spine (Phila Pa 1976). 1998; 23: 1986-1990. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/9779532
Carlson HL, Carlson NL, Pasternak BA, Balderson KD. Understanding and managing the back pain of pregnancy. Curr Womens Health Rep. 2003; 3: 65-71. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12521555
Olsson C, Nilsson- Wilkmar L. Health-related quality of life and physical ability among pregnant women with and without back pain in late pregnancy. Acta Obstet Gynecol Scand. 2004; 83: 351-357. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/15005782
To WW, Wong MW. Factors associated with back pain symptoms in pregnancy and the persistence of pain 2 years after pregnancy. Acta Obstet Gynecol Scand. 2003; 82: 1086–1091. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/14616251